Debating the criteria for brain death
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* D. John Doyle

The article on the bioethics of brain death by Neil Lazar and colleagues does a superb job of covering the basic issues.1 However, one important situation that the authors do not discuss concerns the patient with a massive head injury who meets the criteria for brain death imperfectly, perhaps because a small patch of neurons in a brain-stem nucleus are still operating. In real-world clinical practice such patients have zero chance of survival and so are withdrawn from life support, their organs going to waste.

## Reference

1.  1. Lazar NM, Shernie S, Webster GC, Dickens BM. Bioethics for clinicians: 24. Brain death. CMAJ 2001;164(6):833-6. 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=11276553&link_type=MED&atom=%2Fcmaj%2F165%2F3%2F269.2.atom)